Biomedical subjects

C H Wyndham

Publications and source records attributed to C H Wyndham.

At least 19 recordsLinked to original sources

PubMed1987

Prevalence of hypercholesterolaemia in young Afrikaners undergoing coronary artery bypass surgery. Ischaemic heart disease risk factors.

Ischaemic heart disease risk factors, with particular reference to familial hypercholesterolaemia, were studied in 47 male and 6 female Afrikaners, aged 55 years and under, admitted to hospital for coronary bypass surgery. The outstanding feature in this group with severe coronary atherosclerosis demonstrated angiographically was that about half had severe hypercholesterolaemia (greater than or equal to 8.5 mmol/l), and that of the severely hypercholesterolaemic patients about half again had familial hypercholesterolaemia (FH). This yielded an overall prevalence of FH in the 53 cases of 1 in 4 (26.7%) and strongly supports the contention that FH is a major risk factor for severe coronary artery disease in young Afrikaners. The only other risk factor of importance was cigarette smoking, about 80% of the patients being current or ex-smokers.

Angina, Unstable↗

PubMed1987

Prevalence of hypercholesterolaemia in young Afrikaners with myocardial infarction. Ischaemic heart disease risk factors.

Ischaemic heart disease (IHD) risk factors, with particular reference to familial hypercholesterolaemia (FH), were studied in 39 male and 12 female Afrikaners aged 55 years or under in an intensive care unit immediately after an acute myocardial infarction and in the survivors at about 3 months after the infarct. Two major risk factors were found. Firstly, about three-quarters of both male and female patients smoked more than 15 cigarettes daily. Secondly, 51% of males and 37% of females had serum cholesterol values of greater than or equal to 7.0 mmol/l and about 20% of both men and women had levels of greater than or equal to 8.5 mmol/l. Three male and 2 female patients--1:10 of the whole sample--had FH diagnosed by rigorous criteria, a prevalence similar to the figure of 1:8 predicted from the frequency of FH heterozygotes in the Afrikaans-speaking population. None of the other IHD risk factors such as hypertension, diabetes and hyperuricaemia appeared to be important. The role of obesity appeared to be indirect by virtue of its frequent association with and possible contribution to hypercholesterolaemia. Many of the patients had a history of previous IHD episodes.

Adult↗

PubMed1986

Comparison of mortality rates for cancer in black adults--1970 v. 1980.

Mortality rates (MRs) for cancer in black men and women, aged 25-74 years, in the 34 'selected' (urban) magisterial districts were calculated for 1980 and compared with the MRs for cancer in 1970. All MRs were age-adjusted to the age distribution of the white population in 1970 to enable valid comparisons to be made. A notable feature was the increase in MRs for cancer of the oesophagus and cancer of the lungs over the period. Cancer of the liver was among the three leading causes of deaths from cancer in both black men and women, which contrasted markedly with the situation in the other populations of the RSA. Examination of MRs for all causes of death and of deaths from cancer in the 16.9 million black population in 1980 suggests that there was a very substantial under-reporting of deaths, particularly in the rural areas of RSA. It is estimated that around 60,000 deaths were not reported. The implications of this finding are discussed and an interim solution proposed.

Adult↗

PubMed1986

Mortality rates of black infants in Soweto compared with other regions of South Africa.

Mortality rates (MRs)/100,000 for 1980 were calculated for black infants under 1 year of age for all causes of death and for the leading causes of death--gastro-enteritis, ill-defined causes, perinatal conditions, and the pneumonias--in three regions, Soweto, the 34 'selected' magisterial districts (all urban) and the rural areas in the RSA. The results showed a low MR for all causes of death (2813,7/100,000) and a low ranking of gastro-enteritis (third) in Soweto. In contrast the infant health situation in the 34 'selected' magisterial districts showed an MR from all causes of death which was three times higher (8,594/100,000) than in Soweto and gastro-enteritis was the leading cause of death with an MR 10 times higher than in Soweto. If the infant deaths and infant population in Soweto are subtracted from these figures in the 34 'selected' magisterial districts the MR is 10,156,8/100,000. Valid comparisons between the MRs of the rural areas and either Soweto or the 34 'selected' magisterial districts cannot be made. The MRs of the causes of death in the rural areas of 3,456/100,000 are palpably incorrect and due to under-reporting. An estimation of the under-reporting is that at least 20,000 infant deaths in rural areas were not reported in 1980, compared with the 14,327 deaths which were reported.

Black or African American↗

PubMed1986

Deaths from accidents, poisoning and violence--differences between the various population groups in the RSA.

The pattern of deaths from accidents, poisoning and violence of the four population groups in the RSA for 1980 was examined in terms of the number of male and female deaths, separately and together, of certain WHO International Classification of Diseases (ICD) groupings of deaths from those causes. The main findings were: (i) that motor vehicle accidents (MVAs) accounted for 3.6% of all deaths in whites, 3.7% in coloureds, 3.1% in Asians and 2.2% in blacks, male deaths being 4 times as frequent as female and more than 70% of those deaths occurring in people under 40 years; 6% of MVAs in whites, 38% in coloureds, 17% in Asians and 34% in blacks involved pedestrians; (ii) that the next most common cause of death under these ICD headings was suicide in whites (1.6% of total) and homicide in coloureds (4.8% of total) and blacks (3.9% of total); and (iii) that under the ICD grouping 'other accidents', 45% of those deaths in whites, 58% in coloureds, 79% in Asians and 36% in blacks were due to drowning, with over 80% of deaths from drowning in people under 40 years.

Accidents↗

PubMed1986

Cause- and age-specific mortality rates from accidents, poisoning and violence.

Cause- and age-specific mortality rates (MRs) were calculated for 1980 for all four population groups in the RSA for certain accidents, poisonings and violence as they are grouped in the WHO International Classification of Diseases (ICD). Cause-specific MRs of coloureds, Asians and blacks were age-adjusted to the age-distribution of whites in 1980 in order to judge the relative importance of the various causes of death. This showed that in whites and Asians motor vehicle accidents (MVAs) head the rank order of MRs; furthermore the first three MRs in the rank order, namely for MVAs, suicide and violence, are common in these two populations. A similar situation exists among coloureds and blacks in that the MRs for homicide rank first and the first four causes of death in the rank order of MRs--homicide, MVAs, violence and other accidents--are common to those two population groups. The fact that deaths from MVAs and violence rank so high in the MRs for all four population groups lends support to the contention that the RSA is a 'violent society'.

Accidents↗

PubMed1986

Are mortality rates for respiratory diseases in the RSA affected by climate?

Age-standardized and age-specific mortality rates (MRs)/100 000 of whites for the pneumonias and chronic respiratory diseases averaged over the 3-year period 1979-1981 for four highveld cities, Johannesburg, Bloemfontein, Pretoria and Germiston, were compared with those for four coastal cities, Cape Town, Durban, Port Elizabeth and East London--Durban being in the subtropics. The highveld cities have cold winter climates with air temperatures falling to freezing point in June and July, whereas the winters are mild in the coastal cities. In Durban, for example, the mean minimum monthly air temperature rarely falls below 10 degrees C in winter. Age-standardized MRs for the pneumonias were negatively associated with the average mean monthly minimum air temperatures in June-July. These rates were much higher in the highveld cities (varying from 63,9/100 000 to 71,4/100 000) than in the coastal cities (varying from 29,8/100 000 to 40,7/100 000). Age-specific MRs in the over-75-year age group in highveld cities were twice as high as the MRs of this age group in the coastal cities. Age-standardized MRs for chronic respiratory diseases, on the other hand, were not associated with winter air temperatures in these eight cities. Age-specific MRs for the over-75-year age group were also not related to the winter air temperatures in the eight cities. This lack of association between MRs for chronic respiratory diseases and winter air temperatures might be due to the confounding effect of air pollution.

Age Factors↗

PubMed1986

Effects of personal, environmental and occupational factors on ischaemic heart disease in white miners in South Africa.

The objective of this study was to determine which personal, environmental and occupational factors were associated with risk of non-fatal ischaemic heart disease in a group of 3930 white underground miners born between 1916 and 1930. Evidence of previous myocardial infarction, based on their electrocardiograms and answers to the Rose questionnaire, was found in 179 men who were taken as the cases of interest. Because of difficulties in coding the occupational histories of all available miners, a representative sample of the remaining 'non-infarct' miners was drawn as a reference sample. Univariate analysis of the 179 cases and 669 referents showed that the personal factors such as age, systolic and diastolic blood pressure, serum cholesterol and smoking were significantly different in the two groups at the 1% level of significance. Logistic regression analysis showed similarly that these same variables were significantly associated with IHD when included in a multivariate model. None of the environmental and occupational variables was significant.

Age Factors↗

PubMed1986

Mortality of middle aged white South African gold miners.

A cohort of 3971 white miners in South Africa, born between 1 January 1916 and 31 December 1930 who were alive on 1 January 1970 and currently working in the East Rand-Central Rand-West Rand mining areas, was followed up for nine years, when the 3426 survivors were aged from 48 to 62. Fifteen (0.4%) had been lost to view and 530 had died (13.4% of the 3956 whose vital status was determined). Based on the occupational histories of a 30% sample of the cohort it was known that the vast majority were gold miners. An estimated 93% had worked more than 85% of their mining service in gold mines. Standardised mortality ratios were calculated as the ratios of the deaths observed in the cohort to those expected on the basis of concurrent mortality in the reference population--the total white male population in the Republic of South Africa. There was little sign of a "healthy worker effect"; of several possible reasons, one is that the white miner in South Africa had adopted certain unhealthy life styles, another is that the reference population was otherwise inappropriate. The SMR for all causes of death (117.6) was raised because of excess mortality due to the following causes: lung cancer (161.2), chronic respiratory diseases (165.6), and acute and chronic nephritis (381.0). A case-referent analysis was carried out on those miners in the cohort who had spent at least 85% of their service in gold mines. For lung cancer, smoking was the main contributory factor towards disease. For chronic respiratory diseases bronchitis, emphysema, asthma, pneumoconiosis, and pulmonary heart disease), smoking was also the main risk factor, but there was an association wih cumulative dust exposure. Raised blood pressure, smoking, and adiposity were associated with ischaemic heart disease as was the duration of service underground. Study of comprehensive medical histories in all 530 deaths, including necropsy in most cases, showed that none was directly due to pneumoconiosis or to tuberculosis.

Chronic Disease↗

PubMed1985

Changes in infant mortality rates among whites, coloureds and urban blacks in the RSA over the period 1970-1983.

Using national mortality statistics, we found that infant mortality rates (IMRs) declined among whites and coloureds in the RSA over the period 1970-1983, the decrease in coloured IMR being from 134,8 to 50,7/1 000 and that in white IMR from 21,6 to 12,6/1 000. The decrease in the IMR among coloureds was mainly due to the decline in post-neonatal mortality rates (PNMRs). Since post-neonatal deaths are generally due to gastro-enteritis, pneumonia, malnutrition and measles, the decline in mortality is probably due to a decrease in these causes. The decrease in early neonatal mortality made only a small contribution to the decline in the IMR among coloureds. In the case of whites the decrease in the IMR was largely due to the decline in the early neonatal mortality rate (ENMR); these deaths usually result from low birth weight, the respiratory distress syndrome, asphyxia and infections. The decline in the PNMR played a minor role. National IMRs for blacks are not reported annually, but IMRs can be calculated for the two census years 1970 and 1980 for blacks in 34 'selected' (urban) magisterial districts, and were 124,4 and 85,9/1 000 respectively. A valid IMR for 'rural' Transkei from a well-conducted epidemiological study was 130/1 000 in 1980. The components of the IMRs for blacks can only be determined for certain urban areas with large black populations such as Soweto (adjacent to Johannesburg), where the IMR fell from 81,4/1 000 in 1970 to 25,5/1 000 in 1983. The decline in the IMR was due to decreases in both the ENMR and the PNMR.(ABSTRACT TRUNCATED AT 250 WORDS)

Black or African American↗

PubMed1985

Deaths from and mortality rates for largely preventable causes of death in whites in the RSA. Comparison of the situations in 1970 and 1980.

The numbers of deaths from and age-adjusted mortality rates (MRs) for largely preventable causes of death in white males and females aged 15 - 64 years in 1970 and 1980 were compared. The causes of death considered were lung cancer, ischaemic heart disease (IHD), cerebrovascular disease, chronic lung diseases, cirrhosis of the liver, motor vehicle accidents and suicide. In spite of an increase in the white population in this age group from 2,39 million in 1970 to 2,93 million in 1980, the number of deaths from the above causes decreased, with two exceptions. The exceptions were lung cancer, where the number of deaths increased from 482 in 1970 to 535 in 1980, and suicide--up from 433 to 516. The decreases over the 10-year period were substantial in some cases. For example, the number of deaths from IHD fell from 4000 to 3486. The MRs (those for 1980 were age-adjusted) decreased over the 10-year period in all cases, except in the case of lung cancer where the MR remained at 20/100 000. This seems to indicate that anti-smoking campaigns in RSA have not yet begun to influence the incidence of this disease in the white population.

Accidents, Traffic↗

PubMed1985

A comparison of mortality rates from cancer in white, Indian and coloured adults in 1970 and 1980.

In 1980 lung cancer was associated with the highest mortality rate (MR) in white, Indian and coloured men in the RSA. MRs for this type of cancer were higher in 1980 than in 1970 in all three populations, the increase of 47% in that for coloured men being especially marked. On the other hand, MRs for stomach cancer were lower in 1970 than in 1980 in men from all three populations; however, this type of cancer was still associated with the second highest MR in all groups in 1980. Breast and lung cancer had the highest MRs in white women. In this group there was little change in the MR for breast cancer, but a 27% increase in that for lung cancer over the 10-year period. The three types of cancer associated with the highest MRs in coloured women were cancer of the cervix, breast and stomach. In this group the MR for breast cancer dropped by 22% and that for lung cancer increased by 135% over the 10-year period. In Indian women MRs for cancer of the stomach, breast and cervix ranked highest, a marked increase occurring only in the MR for breast cancer. The MR for lung cancer in Indian women showed a decrease of 71% in 1980 compared with 1970.

Adult↗

PubMed1985

Comparison and ranking of cancer mortality rates in the various populations of the RSA in 1970.

Age-adjusted mortality rates (MRs) in all four population groups in the RSA (age range 25 - 74 years) for different types of cancer were compared and ranked. Lung and stomach cancer had the highest MRs in white, Indian and coloured males. In white males lung cancer ranked 1st (MR more than twice as high as that for stomach cancer), while in Indian and coloured males stomach cancer ranked 1st and lung cancer 2nd. The MR for lung cancer in coloured males was a little higher than that in white males. In black males oesophageal cancer ranked 1st and liver cancer 2nd. In white females breast cancer ranked 1st and lung cancer 2nd. In coloured females cancer of the cervix ranked 1st followed by cancer of the breast and of the stomach. In black females cancer of the oesophagus and of the liver ranked 2nd and 3rd after cancer of the cervix, and in Indian females the rank order was stomach cancer 1st, breast cancer 2nd, and cervical cancer 3rd. Cancers of the rectum and bladder were low in the rank order in both males and females of all four population groups. The main feature of age-specific MRs for the more common cancers was the fact that MRs for stomach cancer in both coloured males and females were relatively high in the younger age groups. Also, the MRs for cancer of the cervix in coloured and black females were not only higher at all ages (except in the highest age group in blacks) but were particularly high in the younger age groups compared with figures for the other populations.

Adult↗

PubMed1984

Leading causes of death among children under 5 years of age in the various population groups of the RSA in 1970.

The mortality rates (MRs) of children under 5 years of age in the various population groups of the RSA were calculated as deaths/10(5) for various causes of death and groupings of causes of death as classified by the International Classification of Diseases. In 1970 the ten leading causes of death among Coloured and Black children under 5 years of age in the RSA were similar to those among children in developing countries. The rank order of causes of death (in MRs/10(5] among Coloured children was as follows: gastro-enteritis (1 733), pneumonia (725), immaturity (405), ill-defined causes of death (168), nutritional deficiencies (167), measles (126), anoxia (97), 'other bacterial diseases' (91), inflammatory diseases of the nervous system (55) and tuberculosis (48). The ten leading causes of death among White children in the RSA were characteristic of children in Western developed countries. The rank order (in MRs/10(5] was as follows: immaturity (144), anoxia (94), pneumonia (46), gastro-enteritis (41), congenital heart disease (32), other accidents (19), birth injury (19), ill-defined causes of death (12) and inflammatory diseases of the nervous system (11).

Canada↗

PubMed1984

Trends in the mortality rates for the ten leading causes of death among white, coloured and Asian children under 5 years of age in the RSA, 1968-1977.

The mean mortality rates (MRs) for the ten leading causes of death among Coloured children in the RSA over the 10-year period 1968-1977 were consistently higher, and in some instances substantially higher, than the MRs among White children; the MRs among Asians were intermediate between those for the White and Coloured children. For certain causes of death the differences between the MRs of White and Coloured children were large; the MR for gastro-enteritis of Coloured children was 42 times higher than that of White children, the MR for tuberculosis was 64 times higher, the MR for measles was 52 times higher, the MR for nutritional deficiencies was 57 times higher, and the MR for pneumonia was 17 times higher. There were, however, certain important causes of death in Coloured children in which dramatic improvements occurred over the 10-year period. For example, the decrease in the MR for gastro-enteritis was 21 times as fast as the change in the MR among White children. Also, the MR for nutritional deficiencies among Coloured children decreased at a faster rate than the MRs among the other children. Unfortunately there were no improvements over the 10-year period in MRs for tuberculosis, measles and pneumonia in Coloured and White children. This is a cause for concern since these are preventable diseases.

Accidents↗

PubMed1984

Update on mortality from ischaemic heart disease in white South Africans.

Mortality rates (MRs) per 100 000 for ischaemic heart disease (IHD) of White males and females in the RSA in the age group 15-64 years decreased substantially in 1980 compared with 1970, the male rates decreasing from 256,1/100 000 to 200,3/100 000 (-22%) and the female rates decreasing from 79,3/100 000 to 56,6/100 000 (-29%). In this period, the White male population increased from 1,20 to 1,48 million and the White female population from 1,18 to 1,45 million, but the number of deaths from IHD fell from 3 064 to 2 720 in males and from 936 to 756 in females. For the year 1980 MRs for acute myocardial infarction (AMI) and IHD in White males and females of the RSA were compared with the MRs of males and females in the USA, Australia, England and Wales, and Scotland. The MRs for both AMI and IHD of males in the USA and Australia fell well below the figure for England and Wales, which contrasted markedly with the situation in 1970. The MRs for AMI and IHD of males in Scotland and the RSA were similar and were much higher than the MRs of males in the other countries. The MRs for AMI and IHD of females in the USA, Australia, and England and Wales were similar and well below the MRs of females in Scotland and the RSA, the MRs of females in Scotland being higher than the MRs of females in all the countries studied.

Adolescent↗

PubMed1983

Trends in age-specific mortality rates for ischaemic heart disease, 1968 - 1977.

Age-specific mortality rates (MRs) were calculated for each year of the period 1968 - 1977 for ischaemic heart disease (IHD) in males and females of the USA, Australia, Finland, Scotland, England and Wales, and of South Africa (Whites). The age range studied, in 10-year intervals, was 15 - 64 years. In the younger age groups (15-24, 25-34 and 35-44 years) the MRs of White South Africans were two to three times as high as those of other populations over the whole 10-year period. In the older age groups the differences narrowed. MRs for IHD in the USA decreased markedly in all age groups over the period studied, the decreases varying from 20% to 40%. Decreases in MRs for IHD also occurred among Australians and Finns but were neither as consistent nor as large as those occurring in the USA. No consistent changes were observed in the other three populations.

Adolescent↗

PubMed1982

Deaths from destructive lifestyles (largely preventable among economically active Whites in South Africa, 1968--1977.

In South Africa, 60% of the deaths economically active (EA) White males and 40--50% among EA White females in recent years were largely preventable, being a result of destructive lifestyles. The most common cause of death was ischaemic heart disease (IHD), accounting for 30% of deaths among EA males and 20% of deaths among EA females. The next most common cause of death was motor vehicle accidents in males (10%), and cerebrovascular diseases (CVA) in females (10%). However, among males in England, Wales and Scotland, lung cancer was the second most common cause of death, and as from 1974 this was also the case among American males. Age-adjusted mortality rates (MRs) of White South African males were compared with the MRs of males in the USA, Australia, England and Wales, and Scotland over the period 1968--1977. The MRs of White South African males were higher than those males in the other populations for IHD, CVA, motor vehicle accidents and suicides, but not for lung cancer and chronic respiratory diseases (highest MR among Scottish males). Over the period 1968--1977 the MRs for IHD were unchanged among males in South Africa (220-250/00 000), Scotland (190/00 000) and England and Wales (150/00 000), but those of males in the USA and Australia fell by 25% and 21% respectively to around 150/00 000 by 1977. MRs for motor vehicle accidents in White males in South Africa fell by 33% in 1974 due to the strict enforcement of lowered speed limits at the start of the oil crisis.

Accidents, Traffic↗